NPIMap

Organization Active NPI

Irina Sumenko, D.D.S., Inc.

Doing business as Wilshire Dental Group

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1457400269
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
42427 Issued in CA
Legal business name
IRINA SUMENKO, D.D.S., INC.
Doing business as
Wilshire Dental Group
Practice address
6200 Wilshire Blvd
Suite # 1104
Los Angeles, CA 90048-5801
Phone
(323) 525-1819
Fax
(323) 525-1883
NPI assigned
Jan 10, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Irina Sumenko, D.D.S.NPI 1003965112
Title
President
Phone
(323) 525-1819

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 42427 CA Primary

Addresses

Primary practice location

6200 Wilshire Blvd
Suite # 1104
Los Angeles, CA 90048-5801

Mailing address

6200 Wilshire Blvd
Suite # 1104
Los Angeles, CA 90048-5801
Phone (323) 525-1819

Other names 1

  • Wilshire Dental Group Doing business as

National Provider Directory

National Provider Directory

Locations

6200 Wilshire Blvd
Ste 1104
Los Angeles, CA 90048
Phone (323) 525-1819

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457400269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6200 WILSHIRE BLVD",
            "address_2": "SUITE # 1104",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485801",
            "telephone_number": "323-525-1819",
            "fax_number": "323-525-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6200 WILSHIRE BLVD",
            "address_2": "SUITE # 1104",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900485801",
            "telephone_number": "323-525-1819",
            "fax_number": "323-525-1883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRINA SUMENKO, D.D.S., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SUMENKO",
        "authorized_official_first_name": "IRINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "323-525-1819",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "42427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wilshire Dental Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.